Access to oral rehydration solution and zinc supplementation for treatment of childhood diarrhoeal diseases in Sudan

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RESEARCH NOTE

Access to oral rehydration solution and zinc supplementation for treatment of childhood diarrhoeal diseases in Sudan Sagad Omer Obeid Mohamed*  , Mansour Osman Alhaj Alawad, Asaad Ahmed Mohammed Ahmed and Ahmed Abdallah Ali Mahmoud

Abstract  Objectives:  The decline in diarrhoeal disease-related mortality globally has been attributed to the use of oral rehydration solution (ORS) and zinc supplementation. However, data on ORS and zinc supplementation in Sudan are scarce. We aimed to investigate the access to ORS and zinc treatments and the associated factors, through the analysis of the latest available data from Sudan-Multiple Indicator Cluster Survey (MICS)-2014 obtained from the United Nations Children’s Fund (UNICEF). Results:  A total of 14,081 children were included in this analysis. During the 2 weeks preceding the survey, 29.3% of these children had a diarrhoeal disease. Only 18.9% and 14.8% of these children had received ORS and zinc supplements, respectively. Whereas children from the higher wealth index groups were more likely to receive ORS treatment (fourth group: AOR = 1.301; 95% CI 1.006–1.682), children from rural areas were less likely to receive ORS treatment (AOR = 0.666; 95% CI 0.552–0.803) and zinc supplements (AOR = 0.603; 95% CI 0.500–0.728). The results indicate the existence of unequal access to treatment of childhood diarrhoeal diseases among children under 5 years in Sudan. Keywords:  Diarrhoea, Children, ORS, Zinc, Epidemiology, MICS Introduction Diarrhoeal diseases create a global health burden with significant morbidity and mortality among children under 5 years in low and middle-income countries [1–3]. About half-a-million diarrhoeal disease-related deaths occur annually, with the highest rates of under-5 year child diarrhoea-related mortality recorded in sub-Saharan Africa and South Asia [1, 4, 5]. Despite improvements in standards of living, diarrhoeal diseases still account for significant economic and social losses [6]. Eradication of most of the preventable deaths due to diarrhoeal diseases could be achieved by scaling up cost-effective interventions [7, 8]. *Correspondence: [email protected] Faculty of Medicine, University of Khartoum, Alqasr Avenue, P.O. Box 102, Khartoum, Sudan

The decline in the total diarrhoeal diseases-related mortality globally has been attributed to the increased use of oral rehydration solution (ORS), zinc supplementation, improved nutrition, hygiene, and sanitation [10– 13]. The World Health Organization (WHO) and United Nations Children’s Fund (UNICEF) recommended ORS and zinc supplementation as a primary treatment for diarrhoeal diseases in children because ORS can reduce diarrhoeal deaths significantly and zinc supplementation can reduce the duration, severity, and recurrence of diarrhoeal diseases in children in the 2 to 3 months following its use [9–13]. Data on childhood diarrhoeal diseases and ORS and zinc supplementation in Sudan are scarce and most of the studies on diarrhoeal disease in Sudan were